Jeanette Fay Peltola, PLC,MA

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401003877 Issued in MI

Practice address

968 Harbor CT
Traverse City, MI 49685-9355

Phone

(231) 632-1370

NPI assigned

Aug 11, 2020

Last updated

Aug 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1033720321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 HARBOR CT",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496859355",
            "telephone_number": "231-632-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "968 HARBOR CT",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496859355",
            "telephone_number": "231-632-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTOLA",
        "first_name": "JEANETTE",
        "middle_name": "FAY",
        "credential": "PLC,MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401003877",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401003877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Peffers, PA-C
• Peg Dunn CNM Nurse-Midwifery Service
• Anthony Peltier
• Christina Marie Peltier, FNP
• Megan Peltier
• Renea Pender
• Kathryn Penfold, M.SC
• Christopher Jakob Penix
• Melissa Pennington
• People in Bloom PLC

• Counselor in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.